[Disorders of the oxygenating function of the lungs during open-heart surgery].
A retrospective analysis of arterial blood oxygenation during open-heart surgery in 463 patients revealed pulmonary oxygenation disorders in 23% prior to perfusion and in 49% in the post-perfusion period. The basic mechanism underlying the fall in arterial blood oxygenation is the increasing venous admixture in the lungs. A growth in the venous admixture in the post-perfusion period is brought about by a decreased total ventilation/perfusion ratio, increased alveolar shunting, and impaired diffusion. It was found, that the assisted ventilation regimen at +5+8 cm H2O in the post-perfusion period caused a 30% reduction in the venous admixture and improved the blood oxygenation. Additional use of diuretics to diminish the intrapulmonary water causes a 59% reduction in the venous admixture. A prophylactic pre-perfusion administration of corticosteroids, vitamin E, and protease inhibitors maintains the oxygenating function of the lungs, which is manifested in a higher blood oxygenation in these patients after assisted circulation compared to the controls.
Buniatian
A A
AA
Trekova
N A
NA
Engoian
G V
GV
Flerov
E V
EV
Asmangulian
E T
ET
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures; D004232:Diuretics / Q000627:therapeutic use; D006801:Humans; D008168:Lung / Q000502:physiology*; D010100:Oxygen / Q000097:blood*; D011480:Protease Inhibitors / Q000627:therapeutic use; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D014810:Vitamin E / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D004232:Diuretics; D011480:Protease Inhibitors; D014810:Vitamin E; D010100:Oxygen
Narushenie oksigeniruiushcheĭ funktsii legkikh vo vremia operatsiĭ na otkrytom serdtse.